The Prophylactic Mastectomy Dilemma: A Support Group for Women at High Genetic Risk for Breast Cancer

The goal of this pilot study was to test the usefulness of a six session psychoeducational support group for women at high genetic risk for breast cancer who were considering prophylactic mastectomy. The themes of the group sessions included overestimation of and anxiety about risk; desire for hard data; the emotional impact of watching a mother die of breast cancer; concerns about spouse reactions; self- and body image; the decision-making process; and confusion over whom to trust in decision making. Both the participants and the multidisciplinary leaders concluded that as a supplement to individual counseling, a support group is a beneficial and cost-effective treatment modality. Recommendations for the optimal format for such a group are described.     

Development of the Critical Elements of Genetic Evaluation and Genetic Counseling for Genetic Professionals and Perinatologists in Washington State

We present a method for the development of consensus documents describing the components of genetic evaluation and genetic counseling for various diagnoses. These documents were developed to encourage consistency among genetic professionals in Washington State. Other possible uses of these documents are to provide information regarding genetic evaluations for health care practitioners and payers, and to assist in quality assurance and genetic training programs. A working group of six genetic professionals developed two templates for the critical elements of genetic evaluation and genetic counseling, for clinical (nonprenatal) and prenatal patients. The working group then completed prototype templates for several specific genetic disorders. The templates and prototypes were sent to interested genetic professionals and perinatologists who submitted a total of 76 draft critical elements (CE's) to the working group. At two statewide meetings, participating practitioners modified and unanimously approved the CE templates, then unanimously approved the 21 draft CEs that had been finalized in small group discussions. Approved CE's were distributed to genetic professionals and perinatologists within the state.     

THE UTILITY OF CURRICULUM-BASED MEASUREMENT FOR EVALUATING THE EFFECTS OF METHYLPHENIDATE ON ACADEMIC PERFORMANCE

Two case studies were conducted to investigate the utility of curriculum-based measurement of math and reading for evaluating the effects of methylphenidate on the academic performance of 2 students diagnosed with attention deficit hyperactivity disorder. Following baseline measurement, double-blind placebo-controlled procedures were employed to evaluate each student's response to three levels (5 mg, 10 mg, and 15 mg) of the medication. Results of the first study suggest that the curriculum-based measures were sensitive indicators of the student's response to medication. This finding was replicated in the second study. In the second study, when the student's follow-up dose of medication was based on trial-phase data, follow-up performance was improved compared to baseline performance. These case studies suggest that further research is warranted on the utility of curriculum-based measurements for monitoring and evaluating stimulant medication interventions with children with this disorder.     

A scale to assess the restrictiveness of educational settings

The placement of students into educational settings is perhaps one of the most debated issues in special education, particularly for students with emotional and behavioral disorders (EBD). A primary consideration in this decision is the restrictiveness of the setting, yet no scale to assess restrictiveness of educational settings exists. We undertook two surveys that asked respondents to rate the restrictiveness of 18 educational placements. The first survey was sent to a national panel of experts, the second survey was sent to supervisors of programs for students with EBD. The results of the surveys led to the development of theScale to Assess Restrictiveness of Educational Settings. This scale is designed to provide a measure of restrictiveness of educational settings that can provide data to evaluate student progress and program outcomes.     

The use and evaluation of study guides with middle school students

Two experiments were conducted with 24 fifth-grade students participating. In the first experiment, quiz performance with study guides was compared to quiz performance without study guides. The group whose students received study guides always scored higher than the group who did not receive study guides. Experiment II assessed the feasibility of students scoring their own study guides. The reliability of student scoring was found to be 93% over all study guides and there were no significant differences between "self-scored" and "teacher-scored" groups on the weekly quizzes.     

A parent advice package for family shopping trips: development and evaluation

THIS ARTICLE REPORTS ON THE PRIMARY STEPS IN THE DEVELOPMENT OF PARENT ADVICE FOR POPULAR DISSEMINATION: (a) developing advice for one specific problem situation, family shopping trips; (b) testing the advice program for benefit to children and convenience to adults; and (c) packaging the advice so it can be used successfully by interested parents. Systematic observation of 12 families using the written advice package on shopping trips revealed its effectiveness in reducing child disruptions and increasing positive interactions between parents and children. These findings, along with interview information from families, showed that the package is usable, effective, and popular with both parents and children, and thus is ready for dissemination to a wide audience of parents-a step that in itself should involve research and evaluation.     

Patrol evaluation research: a multiple-baseline analysis of saturation police patrolling during day and night hours

The effects of a carefully monitored and increased police patrol on the report of crime were examined in four patrol zones. Overall patrol movement was increased to four times normal levels and slow patrol movement (under 20 mph) to around 30 times normal levels for 10 days. The patrol was active in two zones between 9:00 a.m. and 5:00 p.m. and in the other two zones between 7:00 p.m. and 3:00 a.m. A multiple-baseline design and time-series statistical analyses showed statistically reliable changes in reported levels of Part I crime (such as robbery, burglary, and aggravated assault) during both night patrols, but not in the day patrols. In both night-patrol zones, there were also reliable increases from saturation patrol to postsaturation patrol in report of Part I crime after the night patrol was terminated. Neither of the day patrols showed significant crime report changes on termination. Despite statistically reliable decreases in report of crime during nighttime hours, the value of saturation patrolling as a crime-prevention technique was questioned on cost/benefit grounds.     

ON SYSTEMS ANALYSIS IN AUTISM INTERVENTION PROGRAMS

Although intervention technology has grown substantially during the past quarter century, the design of intervention systems has not grown apace. This paper examines organizational arrangements that enhance and diminish treatment effectiveness and argues that defining, measuring, and manipulating systemic antecedent and consequent variables are as important as assessment and intervention on an individual client's behalf.     

Empathy and evaluation: Understanding the private meanings of behavior

This paper makes three points. First, empathy cannot be considered an epistemic basis for qualitative research and evaluation. Second, it is, however, a valuable method for understanding the private meanings of words and deeds. Third, this method is not completely reliable for purposes of what Popper called refutation, but is useful in what he dubbed scientific conjecture or the generation of theory. Basic researchers will need to take the necessary steps to subject empathetic hunches to critical examination. However, owing to the exigencies of action settings and decision-making, disciplined conjectures are sometimes the most that evaluators can hope to record.An earlier version of this paper was printed in the Proceedings of the Far Western Philosophy of Education Society, 1989. This version is published with permission of the Far Western Philosophy of Education society. The author is grateful for helpful comments and critisism made by members of the California Association for Philosophy Education. Remaining errors, of course, are the authors responsibility alone.